Traumatic Bilateral Thoracic Facet Dislocation Without Fracture

摘要

A 46-year-old, man presented with complaints of severe back and chest pain after a 2,000-Ib construction disc fell on him at his worksite. Initial neurosurgical consultation was without focal findings. CT scan of the spine revealed bilateral T4-T5 facet dislocation with 50% canal compromise (A-D). No associated spine fracture was noted. MRI (E, F) demonstrated the facet dislocation (F, arrowheads), but failed to disclose evidence of a spinal cord contusion or traumatic disc hernia-tion. The patient had open reduction and internal fixation of the facet dislocation via frameless stereotaxic-guided pedicle screw fixation (G-J). Postoperatively lie remained neurologi-cally stable and continues to do well at his 18-month followup.